AJOB Empirical Bioethics

VOL. 9 No. 3 | November 2018

11/06/2014

We all know, as Steve Phillips reminded us yesterday, that Brittany Maynard took the pills this past Sunday, one day later than she had originally planned. In the days before that, she appealed to our compassion for her in her suffering—and powerfully at that.Equally powerful were stories from the likes of Kara Tippetts and, as Steve pointed out, Maggie Karner, two women with terminal brain tumors, one metastatic, the other, like Ms. Maynard’s, primary.

The medical details matter less than the shared aspects of these women’s experiences, for, indeed, we take it as axiomatic that such shared experience more than deepens the two responses—it is, we tend to think, a necessary prerequisite. Who can speak to someone without standing in his or her shoes, as the saying goes?Why should someone in present good health presume to be able to speak into the experience of another who is suffering?How can anyone not facing death dare to speak to a terminally ill person, much less lecture her, about physician-assisted suicide?To even address the topic on the grounds of principled argument sounds insensitive, like screaming at another from the depths of an unloving heart.

As a case in point, look back, for example, at Ezekiel Emanuel’s 2012 New York Times blog post, “Four Myths about Doctor-Assisted Suicide.”Look especially at the comments that were posted.(Note that the comments section has long since been closed.)Many of them take the tone of, “Dr. Emanuel, how can you be so cruel?”Now, some, including your current correspondent, think that Dr. Emanuel is often guilty of trying to tell us how our lives should be run, but in this case, his arguments were temperately, even eloquently, made, and I think one is hard pressed to find a mean spirit in them.

The real complaint runs deep—autonomy and personal experience are taken to be normative. But our experiences are embedded in a much broader context, a much larger reality.And that reality demands thoughtful reflection and logical argument to which we subject our individual experience.And, in this case, reflection and argument remind us—as we have been discussing on this blog for a some time now—that dignity in dying calls for care of the whole person but not giving that person a push into the hereafter; that dignity in dying must not be misconstrued into a reason to open doors to much darker scenarios.

Substitution of testimonial for argument may seem like a tempting ethical method in general. As a further example, last month the online Bloomberg Politics ran a story about a project by Planned Parenthood to promote support for abortion on demand by taking a page from the same-sex marriage advocacy playbook and having women who have had abortions canvas, door to door, to tell their stories in the belief that they, and by extension the practice of abortion, will be viewed in a more favorable light.And perhaps that will happen in some cases.Or perhaps they will be received like Jehovah’s Witnesses at the door.But the process cannot negate over 40 years of recent history’s thoughtful—albeit pitched, to be sure—discussions of the matter.Nor should it.And I wonder whether the approach will “travel” in the case of abortion.After all, there is a substantial precedent of “counter stories” from women who decided they would choose life in the moment, or, as a result of changed convictions, in the future. And there is no testimony from the silent, unborn one.And the appeal would be in support of something that the appealer already has, after Roe.And so on.

Individual stories are precious, always to be respected, but not entirely normative. And the “retail politics” of those stories is a poor ethical method.